ADVANCED CARDIOVASCULAR LIFE SUPPORT
EXAM VERSION B EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Recognition and Management of Respiratory and Cardiac Arrest
2. Acute Coronary Syndromes (ACS)
3. Symptomatic Bradycardia and Tachycardia Management
4. Post-Cardiac Arrest Care and Targeted Temperature Management
5. Pharmacology and Dosing Algorithms
6. Effective High-Performance Team Dynamics and Leadership
7. Stroke Recognition and Initial Management
8. Specialized Resuscitation Situations (Pregnancy, Hypothermia, Toxicity)
1. A 65-year-old patient presents with symptomatic bradycardia (HR 38 bpm) and signs of
hypoperfusion. Atropine 1mg has been administered twice without improvement. What is the
most appropriate next therapeutic intervention according to current ACLS guidelines?
A. Administer a third dose of atropine 1mg.
B. Initiate transcutaneous pacing immediately.
C. Start an infusion of amiodarone 150mg over 10 minutes.
D. Perform synchronized cardioversion at 100J.
Answer: B
, CORRECT ANSWER : B
Rationale: Transcutaneous pacing is the recommended next step for unstable bradycardia
refractory to atropine. Option A is ineffective as the maximum dose of atropine has been
reached; C is indicated for ventricular arrhythmias, and D is for unstable tachycardia, not
bradycardia.
2. During a witnessed cardiac arrest, the rhythm is confirmed as Ventricular Fibrillation (VF). After
the first shock, the team resumes CPR. What is the most critical action to perform when
assessing the patient after 2 minutes of CPR?
A. Immediately check for a pulse for 30 seconds.
B. Minimize interruptions in chest compressions to less than 10 seconds while performing a
rhythm check.
C. Intubate the patient while chest compressions are ongoing.
D. Administer a second dose of epinephrine 1mg before checking the rhythm.
Answer: B
CORRECT ANSWER : B
Rationale: Minimizing interruptions in compressions is essential for perfusion. Option A delays
CPR for too long; C is a secondary consideration not prioritized over rhythm checks, and D does
not facilitate immediate resuscitation efforts.
3. A patient is in stable narrow-complex supraventricular tachycardia (SVT). Vagal maneuvers
have failed. What is the appropriate dose and administration method for adenosine?
A. 6mg IV push followed by 20ml saline flush.
B. 6mg rapid IV push followed by 20ml saline flush, then a second 12mg dose if needed.
C. 12mg IV push followed by 20ml saline flush.
D. 300mg IV over 10 minutes.
Answer: B
CORRECT ANSWER : B
Rationale: The initial dose of adenosine is 6mg rapid IV push, followed by a flush to ensure the
drug reaches the heart rapidly. A second dose of 12mg is indicated if the first fails; option A
lacks the second dose, C is the second dose, and D is for cardiac arrest arrhythmias.
,4. A patient is in pulseless ventricular tachycardia (VT). The team has delivered two shocks and
administered the first dose of epinephrine. What is the next drug of choice for a persistent
refractory VF/pulseless VT rhythm?
A. Lidocaine 1mg/kg.
B. Amiodarone 300mg IV/IO bolus.
C. Procainamide 20-50mg/min.
D. Magnesium sulfate 2g.
Answer: B
CORRECT ANSWER : B
Rationale: Amiodarone 300mg is the first-line antiarrhythmic after epinephrine in refractory
shockable rhythms. Lidocaine is an alternative (not first-line), procainamide is for stable
rhythms, and magnesium is indicated for Torsades de Pointes.
5. A patient experiences return of spontaneous circulation (ROSC) after prolonged cardiac arrest.
Post-arrest care is initiated. Which intervention is the highest priority during this phase to
optimize outcomes?
A. Hyperventilating the patient to rapidly reverse acidosis.
B. Maintaining adequate oxygenation and blood pressure, and evaluating for percutaneous
coronary intervention (PCI).
C. Immediately administering a high-dose steroid bolus.
D. Starting prophylactic anti-arrhythmic infusions for all patients.
Answer: B
CORRECT ANSWER : B
Rationale: Post-arrest care focuses on hemodynamic stability, oxygenation/ventilation, and
addressing the underlying cause (often ACS requiring PCI). Hyperventilation (A) decreases
cerebral perfusion; steroids (C) are not standard, and prophylactic drugs (D) are not indicated
for all.
6. A patient presents with acute onset chest pain and ST-segment elevation. What is the primary
therapeutic goal?
A. Delay PCI until a complete neurological assessment is performed.
, B. Minimize the time to reperfusion therapy via Primary PCI or fibrinolytic
administration.
C. Focus solely on pain management using intravenous morphine.
D. Perform a bedside echocardiogram before initiating any antiplatelet therapy.
Answer: B
CORRECT ANSWER : B
Rationale: "Time is muscle" in STEMI; rapid reperfusion is the definitive treatment. Delaying
for neurological assessment (A) or echo (D) loses critical time, and morphine (C) is adjunctive,
not definitive.
7. During high-performance CPR, a team member is providing compressions at a rate of 120/min.
What is the requirement for the depth of these compressions in an adult?
A. 1 to 1.5 inches.
B. At least 2 inches but not more than 2.4 inches.
C. 3 inches.
D. Depth is irrelevant if the rate is correct.
Answer: B
CORRECT ANSWER : B
Rationale: Guideline-driven compression depth for adults is 2 to 2.4 inches to ensure adequate
cardiac output. Depths outside this range are either ineffective (too shallow) or potentially
harmful (too deep).
8. A patient is in Torsades de Pointes (polymorphic VT). What is the specific pharmacological
intervention indicated for this rhythm?
A. Amiodarone 150mg.
B. Magnesium sulfate 1-2g IV/IO over 5-20 minutes.
C. Sodium bicarbonate 50mEq.
D. Atropine 1mg.
Answer: B
EXAM VERSION B EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Recognition and Management of Respiratory and Cardiac Arrest
2. Acute Coronary Syndromes (ACS)
3. Symptomatic Bradycardia and Tachycardia Management
4. Post-Cardiac Arrest Care and Targeted Temperature Management
5. Pharmacology and Dosing Algorithms
6. Effective High-Performance Team Dynamics and Leadership
7. Stroke Recognition and Initial Management
8. Specialized Resuscitation Situations (Pregnancy, Hypothermia, Toxicity)
1. A 65-year-old patient presents with symptomatic bradycardia (HR 38 bpm) and signs of
hypoperfusion. Atropine 1mg has been administered twice without improvement. What is the
most appropriate next therapeutic intervention according to current ACLS guidelines?
A. Administer a third dose of atropine 1mg.
B. Initiate transcutaneous pacing immediately.
C. Start an infusion of amiodarone 150mg over 10 minutes.
D. Perform synchronized cardioversion at 100J.
Answer: B
, CORRECT ANSWER : B
Rationale: Transcutaneous pacing is the recommended next step for unstable bradycardia
refractory to atropine. Option A is ineffective as the maximum dose of atropine has been
reached; C is indicated for ventricular arrhythmias, and D is for unstable tachycardia, not
bradycardia.
2. During a witnessed cardiac arrest, the rhythm is confirmed as Ventricular Fibrillation (VF). After
the first shock, the team resumes CPR. What is the most critical action to perform when
assessing the patient after 2 minutes of CPR?
A. Immediately check for a pulse for 30 seconds.
B. Minimize interruptions in chest compressions to less than 10 seconds while performing a
rhythm check.
C. Intubate the patient while chest compressions are ongoing.
D. Administer a second dose of epinephrine 1mg before checking the rhythm.
Answer: B
CORRECT ANSWER : B
Rationale: Minimizing interruptions in compressions is essential for perfusion. Option A delays
CPR for too long; C is a secondary consideration not prioritized over rhythm checks, and D does
not facilitate immediate resuscitation efforts.
3. A patient is in stable narrow-complex supraventricular tachycardia (SVT). Vagal maneuvers
have failed. What is the appropriate dose and administration method for adenosine?
A. 6mg IV push followed by 20ml saline flush.
B. 6mg rapid IV push followed by 20ml saline flush, then a second 12mg dose if needed.
C. 12mg IV push followed by 20ml saline flush.
D. 300mg IV over 10 minutes.
Answer: B
CORRECT ANSWER : B
Rationale: The initial dose of adenosine is 6mg rapid IV push, followed by a flush to ensure the
drug reaches the heart rapidly. A second dose of 12mg is indicated if the first fails; option A
lacks the second dose, C is the second dose, and D is for cardiac arrest arrhythmias.
,4. A patient is in pulseless ventricular tachycardia (VT). The team has delivered two shocks and
administered the first dose of epinephrine. What is the next drug of choice for a persistent
refractory VF/pulseless VT rhythm?
A. Lidocaine 1mg/kg.
B. Amiodarone 300mg IV/IO bolus.
C. Procainamide 20-50mg/min.
D. Magnesium sulfate 2g.
Answer: B
CORRECT ANSWER : B
Rationale: Amiodarone 300mg is the first-line antiarrhythmic after epinephrine in refractory
shockable rhythms. Lidocaine is an alternative (not first-line), procainamide is for stable
rhythms, and magnesium is indicated for Torsades de Pointes.
5. A patient experiences return of spontaneous circulation (ROSC) after prolonged cardiac arrest.
Post-arrest care is initiated. Which intervention is the highest priority during this phase to
optimize outcomes?
A. Hyperventilating the patient to rapidly reverse acidosis.
B. Maintaining adequate oxygenation and blood pressure, and evaluating for percutaneous
coronary intervention (PCI).
C. Immediately administering a high-dose steroid bolus.
D. Starting prophylactic anti-arrhythmic infusions for all patients.
Answer: B
CORRECT ANSWER : B
Rationale: Post-arrest care focuses on hemodynamic stability, oxygenation/ventilation, and
addressing the underlying cause (often ACS requiring PCI). Hyperventilation (A) decreases
cerebral perfusion; steroids (C) are not standard, and prophylactic drugs (D) are not indicated
for all.
6. A patient presents with acute onset chest pain and ST-segment elevation. What is the primary
therapeutic goal?
A. Delay PCI until a complete neurological assessment is performed.
, B. Minimize the time to reperfusion therapy via Primary PCI or fibrinolytic
administration.
C. Focus solely on pain management using intravenous morphine.
D. Perform a bedside echocardiogram before initiating any antiplatelet therapy.
Answer: B
CORRECT ANSWER : B
Rationale: "Time is muscle" in STEMI; rapid reperfusion is the definitive treatment. Delaying
for neurological assessment (A) or echo (D) loses critical time, and morphine (C) is adjunctive,
not definitive.
7. During high-performance CPR, a team member is providing compressions at a rate of 120/min.
What is the requirement for the depth of these compressions in an adult?
A. 1 to 1.5 inches.
B. At least 2 inches but not more than 2.4 inches.
C. 3 inches.
D. Depth is irrelevant if the rate is correct.
Answer: B
CORRECT ANSWER : B
Rationale: Guideline-driven compression depth for adults is 2 to 2.4 inches to ensure adequate
cardiac output. Depths outside this range are either ineffective (too shallow) or potentially
harmful (too deep).
8. A patient is in Torsades de Pointes (polymorphic VT). What is the specific pharmacological
intervention indicated for this rhythm?
A. Amiodarone 150mg.
B. Magnesium sulfate 1-2g IV/IO over 5-20 minutes.
C. Sodium bicarbonate 50mEq.
D. Atropine 1mg.
Answer: B
